Prospective Evaluation of Serum Uric Acid as a Risk Factor for Acute Ischemic Stroke in Adult Patients Compared to Normouricemic Individuals

Abstract

Background: Acute ischemic stroke (AIS) is a leading cause of morbidity and mortality worldwide. While traditional risk factors like hypertension,diabetes, and dyslipidemia are well-established, the role of serum uric acid (SUA) as a potential independent risk factor remains under investigation. Hyperuricemia may contribute to endothelial dysfunction, oxidative stress, and vascular inflammation, thereby increasing stroke risk. Aim: To evaluate the association between serum uric acid levels and acute ischemic stroke and assess its correlation with stroke severity in adultpatients attending a tertiary care center in Bihar, India. Methodology: This prospective observational study enrolled 110 AIS patients and 110 age- and sex-matched normouricemic controls duringthe study period. Clinical evaluation, laboratory investigations including serum uric acid, and neuroimaging (CT) were performed. Stroke severitywas assessed using the NIH Stroke Scale (NIHSS). Statistical analysis included t-tests, chi-square tests, correlation analysis, and multivariatelogistic regression to determine independent risk factors for AIS. Results: Mean SUA levels were significantly higher in AIS patients compared to controls (6.9 ± 1.4 mg/dL vs 5.3 ± 1.2 mg/dL, p < 0.001). Hyperuricemia was observed in 52.7% of AIS patients versus 20% of controls. Elevated SUA correlated positively with NIHSS scores, indicatinggreater stroke severity. Logistic regression identified hyperuricemia as an independent risk factor for AIS (OR 3.8, 95% CI 2.1–6.8, p < 0.001),along with hypertension and smoking. Conclusion: Elevated serum uric acid is significantly associated with the occurrence and severity of acute ischemic stroke, serving as a modifiable,independent risk factor. Routine SUA assessment may aid early risk stratification and preventive strategies in high-risk populations.